Hunter - Paediatric Development And Networking Course Emergency Services (Paed DANCES)
The Paed DANCES program consisted of a two-week supernumerary placement of Staff from smaller rural sites to the JHH emergency. The course was aimed at Registered nurses currently working in any rural emergency department in Hunter Health. During the two-week period the supernumerary shifts were structured so that for the first week the staff were allocated to work with a preceptor. This allowed the participant to be orientated to the department and for the identification of key learning goals. This program was designed in response to the Sinclair report (March 2000), NSW Nursing Workforce Action Plan (Sept 2001) and the Emergency Department services Plan (July 2001), in which the following key issues in relation to nursing staff were identified:
- Competency reinforcement and retention
- Area standardisation of work practices
- Increased networking amongst all Hunter Health emergency departments and Kaleidoscope
- Staff satisfaction
- Career development
- Structured mentor program between metropolitan and rural emergency services
- Provision of a supportive learning environment for all staff.
It is envisaged the Paed DANCES program will have the following secondary outcomes:
- Improved patient outcomes in the emergency care setting
- Address current workforce issues of recruitment and retention
- Organisational need to meet the broader needs of the community
Adult learning principles were adopted. The program was intended to address the key issues identified above so prescriptive learning goals were inappropriate. Each participant took to the program his or her own individual experience, agenda and goals; hence learning goals were individualised. To achieve this each participant was required to demonstrate his or her learning by completion of a learning contract. The learning contract was negotiated by the course supervisors before commencement of the program and reviewed after the first supernumerary week so that appropriate adjustments could be made. Placement participants are now expected to provide education sessions in relation to their learning contract at their home facility.
The project was very successful in giving Rural Registered Nurses the opportunity to gain clinical experience and education at a tertiary facility that has a variety of paediatric presentations. Each participant identified their need of learning prior to there commencement and in some cases were able to then identify other areas of educational needs with the opportunity to work in an environment that is challenging and practical, with the added opportunity to work supernumerary and therefore being able to learn without the added pressure of responsibility (which is often limiting in a confronting environment).
The supernumerary participation was where the participants buddied up with a CNS. The overall success of the Paeds DANCES Project has been encouraging, with most participants gaining resourceful paediatric emergency experience in a limited time frame.
The fallout from the Rural RN experience will hopefully be that their knowledge is utilised on a day-to-day basis in their rural work site along with paediatric education being delivered to the site from the Participants.
An interesting outcome has been the networking between participants and staff at the JHH ED, this experience has also given the Rural Nurses the opportunity to see the day to day dramas a Paediatric ED nurse goes through, and the processes in place to meet these challenges and to deal with them.